Arthritis & Rheumatism, Volume 62, November 2010 Abstract Supplement

Abstracts of the American College of Rheumatology/Association of Rheumatology Health Professionals Annual Scientific MeetingAtlanta, Georgia November 6-11, 2010.

MRI-Proven Bone Edema of Wrist and Finger Joints at Entry Is the Strongest Predictor toward Further Radiografic Progression in Patients with Undifferentiated Arthritis: Results from the Prospective Cohort at Nagasaki University.

Purpose of Study:

We have published the importance of autoantibodies and MRI-proven joint damages of wrist and finger joints toward the prediction of development of rheumatoid arthritis (RA) from undifferentiated arthritis (UA) in Arthritis Rheum 2009: 65; 7518. By using the same patients population, we have tried to find what variables at entry are able to predict the further plain radiografic progression in patients with UA.

Methods:

Our cohort included 129 patients of UA. In the present study, we have focused on the 75 out of 129 patients who developed RA at 1 year. Among 75 patients, all of the follow-up data, including serial plain radiography of both hands, were completed in 58 patients. We have examined, by univariate and multivariate analyses, to determine what variables at entry predict the plain radiographic progression at 2 years calculated by Modified Genant Sharp score. Annual progression value greater than 1 was considered as plain radiografic progression.

Results:

After the follow-up of 2 years, eighteen patients were classified as having plain radiografic progression (progression group) whereas 40 were not (non-progression group). The multiple logistic regression analysis was conducted to determine the independent effects of variables on radiographic progression. The variables were included in the model if the p value was less than 0.20 in univariate analyses. Duration of morning stiffness, CRP, DAS28-CRP, MMP-3, anti-CCP antibodies, RF, MRI-proven symmetrical synovitis and MRI-proven bone edema were selected. Logistic regression analysis have revealed that MRI-proven bone edema is the first (p=0.023, Odds ratio 13.84) and RF is the second (p=0.049, Odds ratio 6.65) predictors toward plain radiografic progression.

Conclusions:

Our data suggest that bone edema of wrist and finger joints at entry is the strongest predictor toward further radiografic progression in patients with UA.